A New Ultrasonographic “Fluttering Sign” for Hepatic Hemangioma

The aim of the study described here was to clarify the diagnostic value of the fluttering sign, a new sign that characterizes hepatic hemangiomas in gray-scale ultrasonography (US). It refers to a phenomenon in which the speckled echogenicity inside the hemangioma changes continuously and seems to be moving. A total of 172 hemangiomas diagnosed with contrast-enhanced US were evaluated. The fluttering sign was found in 123 of 172 hemangiomas (71.5%). Its prevalence was significantly higher than that of the marginal strong echo (89/172, 51.7%, p < 0.001), posterior acoustic enhancement (103/172, 59.9%, p = 0.031) and chameleon sign (100/172, 58.1%, p = 0.013). In addition, the fluttering sign was observed significantly more frequently in mixed or hypo-echoic tumors than in hyper-echoic tumors (p < 0.001), relatively large tumors (p < 0.001) and tumors that were less than 5 cm from the body surface (p = 0.015). The fluttering sign in gray-scale US has great potential to be a new complementary sign for the diagnosis of hemangioma.     

Recovery-oriented daily care practice for community-based mental health service consumers in Japan: A grounded theory approach

Recovery, which is a non-linear, unique process allowing mental health service consumers to live autonomously, has become a prominent concept. However, adapting recovery-oriented practice to daily care is challenging. We explored recovery-oriented practice among mental health professionals in Japan via semi-structured interviews including nurses, occupational therapists, and psychiatric social workers (17 professionals in total). Data were analysed using grounded theory. Six categories emerged. The core category was ‘Continuing to adjust care to meet consumers’ needs for their unique lives'. The professionals stated that they practised in accordance with the service consumers' sincere hopes based on an equitable relationship because they believed that this approach would enhance consumers' personal agency, proactive behaviour, and self-choice. Despite negative consequences, the professionals did not view the consumers' choices as ‘failures' and instead helped them to find meaning in their experiences. Although the therapeutic relationship tended to be paternalistic, participants described how concrete practices helped build an equitable relationship. In recovery-oriented practice, the provision of support centred on consumer values is important, without imposing own's own values. Care practices should also be aligned with consumers' hopes, needs and goals.     

Dendritic cells that endocytosed antigen-containing IgG-liposomes elicit effective antitumor immunity

Liposomes represent a promising vehicle to deliver exogenous antigens to dendritic cells (DCs) for tumor immunotherapy. Targeting exogenous antigens to Fcgamma receptors on DCs has been shown to result in efficient presentation of antigen-derived peptides on major histocompatibility complex (MHC) class I and class II molecules. In this study, it was investigated whether DCs that endocytosed physicochemically optimized antigen-containing liposomes conjugated with IgG efficiently present antigens on MHC class I and class II molecules, and consequently induce strong antitumor immune responses. IgG-conjugated liposomes that were 200 nm in diameter without attaching polyethylene glycol were most efficiently endocytosed by DCs. Human monocyte-derived DCs that endocytosed tetanus toxoid (TT)-containing IgG liposomes via CD32 stimulated CD4(+) T cells more strongly than DCs pulsed with TT-containing bare liposomes or with soluble TT. Immunization of mice with DCs that endocytosed ovalbumin (OVA)-containing IgG liposomes but not OVA-containing bare liposomes or soluble OVA completely prevented the growth of OVA-expressing lymphoma cells. Importantly, administration of DCs that endocytosed OVA-containing IgG liposomes to the mice with established OVA-expressing tumors strongly suppressed tumor growth. This study demonstrates an IgG liposome with physicochemical properties suitable for delivering antigens to DCs and paves the way to the application of IgG liposomes for tumor immunotherapy using DCs.     

Ultrasonic measurement of the effects of light irradiation and presence of water on the polymerization of self‐adhesive resin cement

Self‐adhesive resin cements are useful in restorations because they reduce the number of clinical steps involved in the restoration process. This study evaluated, using ultrasonic measurements, the influence of light irradiation and the presence of water on the polymerization behavior and elastic modulus of a self‐adhesive resin cement. A self‐adhesive resin cement (RelyX Unicem 2 Automix) or a resin cement (RelyX ARC) was inserted into a transparent mold on a sample stage, and the presence of water and effect of light‐irradiation were evaluated. The transit time of a sonic wave through the cement disk was divided by the specimen thickness to obtain the sonic velocity, and longitudinal and shear waves were used to determine the elastic modulus. When the resin cements were light‐irradiated, the sonic velocity rapidly increased and plateaued at 2,500–2,700 m s^?1. When the cements were not irradiated, the rates of increase in the sonic velocity were reduced. When water was applied to the sample stage, the sonic velocity was reduced. The elastic modulus values of the specimens ranged from 9.9 to 15.9 GPa after 24 h. The polymerization behavior of self‐adhesive resin cements is affected by the polymerization mode and the presence of water.     

An alternative index for evaluating AMU and anti-methicillin-resistant Staphylococcus aureus agent use: A study based on the National Database of Health Insurance Claims and Specific Health Checkups data of Japan

IntroductionAnti-methicillin-resistant Staphylococcus aureus (MRSA) agents have different doses and administration periods. Thus, it is difficult to evaluate antimicrobial use (AMU) of anti-MRSA agents using defined daily doses per 1000 inhabitants per day (DID) or days of therapy per 1000 inhabitants per day (DOTID). This study aimed to evaluate the relationship between anti-MRSA agent use and resistant bacteria using the number of patients per 1000 inhabitants per day (PID) as an alternative index of AMU.MethodsAMU data for anti-MRSA agents were collected from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) in 2016. The relationship between PID and DID or DOTID was evaluated. The number of patients with MRSA isolated was obtained from Japan Nosocomial Infections Surveillance, and their correlation with PID was analyzed. The rate of anti-MRSA agent use in each prefecture was investigated.ResultsPID showed a significant linear relationship with both DID and DOTID (all p < 0.0001). PID was significantly correlated with the number of patients with MRSA isolated. Additionally, the rate of anti-MRSA agent use was markedly different in each region.ConclusionsPID is not affected by doses and administration periods, and thus may be an alternative index for the selective pressure of antibiotics. Evaluating AMU using PID based on NDB data will help in the development of effective antimicrobial resistance measures.     

Oncolytic Virus Therapy with HSV-1 for Hematological Malignancies

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Effective exercise intervention period for improving body function or activity in patients with knee osteoarthritis undergoing total knee arthroplasty: a systematic review and meta-analysis

Background

Various systematic reviews and/or meta-analyses examining the effects of pre- or postoperative exercise on body function or activity in patients undergoing total knee arthroplasty (TKA) have been published. However, the interventional period needed to at least improve outcomes is unknown.

Facial nerve regeneration using basic fibroblast growth factor‐impregnated gelatin microspheres in a rat model

Basic fibroblast growth factor (bFGF) plays a crucial role in the regeneration of peripheral nerve defects by affecting nerve cells, Schwann cells and fibroblasts, and by promoting axon outgrowth from the proximal nerve stump. However, the use of exogenous bFGF for in vivo regeneration of the peripheral nerves is limited by its short in vivo half‐life. In this study, a drug delivery system for bFGF was developed that uses acidic gelatin hydrogel, which sustainably released bFGF in vivo over several weeks; its ability to promote peripheral nerve regeneration was also examined. In 8‐week‐old Lewis rats, 7‐mm gaps were made in the buccal branch of the left facial nerve. Acidic gelatin hydrogel microspheres (10 µl) with or without bFGF (50 µg) were infused into a 10 mm silicone tube using a micropipette, and the silicone tube was then implanted into the gap. A 1‐mm long nerve stump was inserted into each end of the tube. Histological examination at 7 weeks after implantation revealed (1) a significantly increased rate of nerve regeneration, (2) inducement of a number of regenerating nerve axons, and (3) a better degree of maturation of nerve axons in the bFGF microsphere group than that in the bFGF‐free microsphere group. Copyright © 2014 John Wiley & Sons, Ltd.     

Brain networks involved in haptic and visual identification of facial expressions of emotion: An fMRI study

Previous neurophysiological and neuroimaging studies have shown that a cortical network involving the inferior frontal gyrus (IFG), inferior parietal lobe (IPL) and cortical areas in and around the posterior superior temporal sulcus (pSTS) region is employed in action understanding by vision and audition. However, the brain regions that are involved in action understanding by touch are unknown. Lederman et al. (2007) recently demonstrated that humans can haptically recognize facial expressions of emotion (FEE) surprisingly well. Here, we report a functional magnetic resonance imaging (fMRI) study in which we test the hypothesis that the IFG, IPL and pSTS regions are involved in haptic, as well as visual, FEE identification. Twenty subjects haptically or visually identified facemasks with three different FEEs (disgust, neutral and happiness) and casts of shoes (shoes) of three different types. The left posterior middle temporal gyrus, IPL, IFG and bilateral precentral gyrus were activated by FEE identification relative to that of shoes, regardless of sensory modality. By contrast, an inferomedial part of the left superior parietal lobule was activated by haptic, but not visual, FEE identification. Other brain regions, including the lingual gyrus and superior frontal gyrus, were activated by visual identification of FEEs, relative to haptic identification of FEEs. These results suggest that haptic and visual FEE identification rely on distinct but overlapping neural substrates including the IFG, IPL and pSTS region.